GLOBAL HEALTH

A healthy dose of Sesame for children worldwide In the battle against serious illness — from heart disease to malaria — education is the first and most important line of defense.

And the earlier it starts, the more effective it can be. That’s why is committed to delivering high-quality health education to young children around the world, helping them grow up strong in body as well as in mind.

Through local versions of and special outreach programs, we’re taking on some of the world’s toughest health challenges, such as HIV/AIDS in , malaria in Tanzania, Lola and childhood obesity in the U.S. and Latin America. As research tells us, programs like these may be just the right prescription for giving children a healthy start in life. Playful 4-year-old Lola loves to exercise and enjoy nature. She’s forever leading her friends on active adventures to discover new healthy habits in the Latin American version of Sesame Street, Plaza Sésamo. GLOBAL HEALTH

HIV/AIDS

South Africa & Southern Africa That’s why we created one of the world’s first Working closely with specialists in HIV/AIDS media-based HIV/AIDS curricula for children. education and international organizations HIV/AIDS touches nearly every family and Our efforts are fostering new openness about focused on the disease, we developed a community in South Africa, including young the disease in countries throughout Southern curriculum for young children that addresses children. Approximately 1 in 8 children have Africa thanks to the example of , a vivacious HIV and AIDS education in three crucial areas: lost a mother, a father, or both to the disease.1 Muppet who happens to be HIV-positive. knowledge, attitudes, and skills. For children, the psychological and social consequences of the epidemic are profound. Opening Life-Saving Lines The result is our TV program Yet a culture of silence surrounds HIV and AIDS. of Communication and outreach initiative in South Africa, Namibia, In our extensive background studies in Nigeria, Botswana, Lesotho, and Swaziland. In dealing with these tough circumstances, South Africa, we found that HIV/AIDS confronted children and adults need better information parents and caregivers with a host of and easier ways to talk about the disease. Goals of our HIV/AIDS curriculum challenges — not only the pain of illness, Communication is a powerful medicine against death, and dying, but dealing with the stigma Knowledge an epidemic perpetuated by silence, stigma, that surrounds the disease. What’s more, 1. Basic information and fear. our research found children had very limited 2. HIV and AIDS transmission knowledge of the facts about the disease, 3. Standard precautions despite its enormous impact on their lives. 4. HIV and AIDS symbols 5. Knowledge about death and dying 6. Body awareness

Attitudes 1. Humanization and destigmatization 2. Open discussion

Skills 1. Coping with HIV and AIDS 1 in 8 2. Coping with illness Approximately 1 in 8 South African children 3. Coping with death and dying have lost a mother, a father, or both to HIV/AIDS.1 GLOBAL HEALTH

Meet Kami

At the heart of Takalani Sesame is Kami, a 5-year-old Muppet who lives with HIV. Parents and caregivers who Our furry star is eager to share her creativity viewed our South African and enthusiasm about life, along with a TV special, “Talk to Me,” were wealth of information about HIV/AIDS. Kami twice as likely to talk with loves to be part of the action, such as when their children about HIV than playing the “train game” in which everyone those who had not watched.5 joins together and chugs along. To play this game, her friends have to touch her, and the sight of a Muppet who is HIV-positive Measurable Impact TV special “Talk to Me,” in which adults and linked together with other kids, playing 2xTakalani Sesame is moving the needle on children communicate about HIV and AIDS. and laughing, is the secret of her success. HIV/AIDS awareness and attitudes, a fact After two weeks, researchers evaluated demonstrated by two in-depth studies. The first changes in their attitudes. Though Kami is HIV-positive, the show’s study assessed changes in knowledge and producers determined that her character Parents and caregivers who viewed “Talk to Me,” behavior around HIV/AIDS among 175 children, should be asymptomatic to counter the were twice as likely to talk with their children 89 parents, and 20 preschool teachers after 3 misperception that everyone with HIV is about HIV than those who had not watched. 10 weeks of exposure to Takalani Sesame.2 sickly. They also chose to make her female, The program’s impact goes far beyond since the disease affects a disproportionate The results were impressive. Children exposed preschoolers. That conclusion is confirmed by number of young girls and women. to Takalani Sesame showed measurable gains a national survey of HIV prevalence, incidence, in HIV/AIDS knowledge and attitudes, including behavior, and communication commissioned Orphaned after her mother died of an AIDS- basic knowledge of the disease, blood safety, by The Foundation. The survey related illness, Kami openly expresses her destigmatization, and coping with illness. In showed that “although Takalani Sesame is feelings in situations that children can relate fact, those children were four times more likely primarily a children’s programme, it achieves to, such as playing with friends or going to the 1 to have some knowledge of HIV/AIDS, while high awareness across all age groups.” doctor. She helps kids learn basic facts about their attitude toward destigmatization of the how HIV is — and isn’t — transmitted, while We’re seeing a similar impact in other parts of disease improved fivefold compared to those Africa as well. In Nigeria, one study showed modeling ways to deal with grief and loss. 2 who were not exposed. that after exposure to Takalani Sesame content, The second study consisted of 349 caregivers 93 percent of children think it’s OK to play with (parents, educators, or other significant adults) a person who has HIV/AIDS, compared with only 4 of children ages 3 to 9.3 Caregivers in the 38 percent before exposure. intervention groups watched Takalani Sesame’s

REFERENCES 1 Nelson Mandela Foundation (2005). South African National HIV Prevalence, HIV Incidence, Behavior, and Communication Survey. Cape Town, South Africa: Human Sciences Research Council Press. 2 Khulisa Management Services (2005). Impact assessment of Takalani Sesame Season II Programme. Johannesburg, South Africa. 3 Health and Development Africa (2005). Impact assessment of a new programming component on HIV/AIDS for Takalani Sesame. Johannesburg, South Africa. 4 Sesame Street Nigeria Team (2009). Sesame Street Nigeria pilot child study: Findings from an informal assessment of children. [Report prepared for Sesame Workshop]. Abuja, Nigeria: Sesame Street Nigeria. GLOBAL HEALTH

Childhood Obesity

United States & Latin America Through Sesame Street in the U.S. and its In Latin America, Plaza Sésamo reaches Latin American version, Plaza Sésamo, which millions of kids at an age when they’re most The rate of childhood obesity in the United States is seen by millions throughout Latin America, receptive to healthy influences. The long- has tripled in the past 30 years. Presently, 1 in 3 we’re instilling healthier habits early on. standing show and its lovable Muppets have U.S. children is overweight or obese. Colombia, Fun songs and colorful characters are setting gained enormous trust and popularity, leading like many other countries, is also facing children on track for a lifetime of wellness. to an alliance in 2006 with Dr. Valentin Fuster an epidemic of obesity and related illness. from the Mount Sinai School of Medicine in Cardiovascular disease claims more Colombian Better Nutrition, Exercise, New York City. Dr. Fuster is the driving force lives each year than do violence, hunger, and and Habits to the Rescue behind a campaign to make heart-healthy communicable diseases combined. Since 2004, we’ve integrated messages habits part of everyday life in Colombia. about healthy food choices and exercise into Sesame Street is working to reverse these Sesame Street as part of our Healthy Habits for of Plaza Sésamo give Dr. Fuster’s trends by connecting with preschoolers when Life initiative. In one show and public-service message lively expression, modeling positive they are forming their eating, exercise, and announcement, First Lady Michelle Obama behaviors in ways that engage children — such hygiene habits. It turns out that Sesame Street’s pops by to plant a vegetable garden with , as a song about tasty fruits or an energizing video furry friends have a remarkable ability to explaining how foods you grow help you grow about fun-filled adventures. Healthy lessons promote better choices. up big and strong. such as these enliven the 50 Plaza Sésamo episodes, as well as a one-hour television special We’ve also delivered a multimedia outreach featuring the First Lady of Colombia. program to child-care providers and at-risk families. In the program, fruits and vegetables To reinforce the learning in schools and literally talk back to their pint-size critics, advising community centers, our Plaza Sésamo kids to “Eat your rainbow!” and “Move your Muppets appear in storybooks, posters, body!” To date almost six million families and and (a favorite of teachers) a game that gets child-care centers have received one of our the whole class moving and kids’ hearts health-focused outreach kits.7 pumping. As key influencers in children’s 1 in 3 education, the teachers in the program The rate of childhood obesity in the get training directly from cardiologists, United States has tripled in the pediatricians, and health educators. past 30 years. Presently, 1 in 3 U.S. children is overweight or obese. GLOBAL HEALTH

Measurable Impact A study in Mexico found a similar connection: In the fight against childhood obesity, Sesame Pairing healthy food with a Sesame Street Street is making a healthy difference. Research character increases children’s likelihood of 3 with U.S. kids shows that when a healthy choosing it over unhealthy food by 10 percent. food is promoted by a Sesame character, When U.S. child-care providers used our children eat 31 percent more of it than when it’s educational outreach kits, almost all (98 percent) 1 promoted by an unknown character. Another report children making improved food choices study suggests that when Elmo promotes such as eating more fruits and vegetables.4 And broccoli, children’s interest in eating broccoli the message hits home, too: Families report a 2 over chocolate increases by 127 pecent. much greater willingness to incorporate healthy foods in their diet — products such as fruits, 68% vegetables, whole grains, and lower-fat milk 68 percent of Mexican families 5 see increases as high as 18 percent. using our Healthy Habits Similar efforts are paying off in Latin America, materials report positive changes where Colombian children saw a 15 percent in their children’s nutrition and improvement in knowledge, attitudes, and hygiene habits.3 habits related to healthy nutrition and active lifestyle after an eight-month intervention.6 In REFERENCES Mexico, the vast majority of families (68 percent) 1 Kotler, J.A., Schiffman, J.M., & Hanson, K.G. (2012). The influence of using our Healthy Habits outreach materials media characters on children’s food choices. Journal of Health Communication. report positive changes in their children’s 2 Cohen, D. & Kotler, J. (2005). Preschoolers’ perception of healthy food. Paper presented at the Biennial Meeting of the Society for Research nutrition and hygiene habits. Likewise with in Child Development, Atlanta, Georgia. teachers: As many as 71 percent of teachers 3 Consultores en Investigación y Comunicación (CINCO). (2009). “Hábitos saludables para toda la vida”, Summary of Findings from report that the Healthy Habits materials Impact Assessment, Yucatán, Mexico: CINCO. help their students learn healthy lessons.3 4 KidPoint, LLC. (2009). Healthy Habits for Life Child Care Resource Kit A 2012 U.S. study concludes that Evaluation Report. Unpublished report. when children are shown fruits and 5 Ritchie, L.D., Whaley, S.D., Spector, P., Gomez, J., Crawford, P.B. (2010). Numbers such as these hold the promise Favorable Impact of Nutrition Education on California WIC Families. vegetables linked with favorite of fitter, thriving families and communities for Journal of Nutrition Education & Behavior, 42(3S). 6 Mount Sinai Cardiovascular Institute, Fundación Cardioinfantil – , they choose years to come. It’s amazing what a healthy Instituto Cardiología, Sesame Workshop. (Forthcoming). Impact of an 8-month intervention on knowledge, attitudes, and habits of those foods at a much higher rate — dose of Sesame can do. preschoolers towards an active lifestyle and healthy diet. 1 and eat more of them. Even broccoli. 7 Sesame Workshop project records, 2011. GLOBAL HEALTH

Malaria

Tanzania nets and information to Tanzanian children and ABOUT SESAME WORKSHOP their families. The campaign included Takalani In a country where only 33 percent of children As the creators of Sesame Street and other Sesame public-service announcements, have access to preschool education1, our Kilimani children’s programming, the mission of the storybooks, and posters with simple but critical Sesame initiative in Tanzania is delivering life- nonprofit Sesame Workshop is focused on lessons like staying inside when the sun goes saving health messages and other learning helping kids learn, grow, and reach their full down and sleeping under insecticide-treated opportunities to millions of children. potential. Our goal is to make learning fun mosquito nets. These efforts have proven to be at home and in the classroom by combining This multimedia program reaches Tanzanian a powerful force in the fight against the disease: our lovable Muppets, sophisticated use of preschoolers through radio, television, and After using Kilimani Sesame materials, a study media, and a curriculum that addresses kids’ outreach materials. Lauded by local educators showed that children know significantly more critical developmental needs. We work in 2 and endorsed by luminaries such as First Lady about malaria transmission and prevention. partnership with parents, educators, and child Mama Salma Kikwete, Kilimani Sesame experts to find appropriate ways to address confronts critical issues in a playful and the unique needs of today’s children, from engaging way, blending lessons on literacy teaching ABCs and 123s to delivering lessons and math with awareness messages about REFERENCES 1 UNESCO Institute for Statistics (2009). Education (all levels) profile — about health, emotional well-being, and malaria and HIV/AIDS.1 United Republic of Tanzania: Pre-primary enrollment. Retrieved social tolerance around the world. October 6, 2011 from http://stats.uis.unesco.org/unesco/ TableViewer/document.aspx?ReportId=121&IF_Language=eng&BR_ Through a collaboration with the nonprofit Country=7620&BR_Region=40540. Malaria No More, Kilimani Sesame was part of 2 Borzekowski, D. L. G., & Macha, J. E. (2010). The role of Kilimani Sesame in the healthy development of Tanzanian preschool children. a campaign to spread insecticide-treated bed Journal of Applied Developmental Psychology, 31, 298-305.

To learn more about funding opportunities, 6-year-old Zuzu sleeps please contact Anita Stewart, Senior underneath a bed net. Vice President, Strategic Partners & Now Tanzanian children Development, Sesame Workshop, at know how important it [email protected] +1 212 875 6889 is to do the same.